Provider Demographics
NPI:1063570729
Name:KOR, JOY (CNM)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:KOR
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 BLAKE AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-4288
Mailing Address - Country:US
Mailing Address - Phone:970-928-7717
Mailing Address - Fax:970-928-7727
Practice Address - Street 1:1905 BLAKE AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-4288
Practice Address - Country:US
Practice Address - Phone:970-928-7717
Practice Address - Fax:970-928-7727
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN40455176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07404551Medicaid
CO840446259073OtherRMHMO